Active NPI
Tracy Rachmiel, PH.D.
- Clinical Psychologist
- Staten Island, NY
National Provider Identifier
1144530296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 013662-1
- Practice address
- 777 Seaview Ave
SBPC Adolescent Day Treatment
Staten Island, NY 10305-3409 - Phone
- (718) 667-2689
- Fax
- (718) 668-8054
- NPI assigned
- Oct 7, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 013662-1 | NY | Primary |
Addresses
Primary practice location
777 Seaview Ave
SBPC Adolescent Day Treatment
Staten Island, NY 10305-3409
Mailing address
777 Seaview Ave
Staten Island, NY 10305-3409
Phone (718) 667-2689
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013662-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712534400000",
"number": "1144530296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053409",
"telephone_number": "718-667-2689",
"fax_number": "718-668-8054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 SEAVIEW AVE",
"address_2": "SBPC ADOLESCENT DAY TREATMENT",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053409",
"telephone_number": "718-667-2689",
"fax_number": "718-668-8054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RACHMIEL",
"first_name": "TRACY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-07",
"last_updated": "2024-04-08",
"certification_date": "2024-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "013662-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.